Clinicians and researchers say lipoprotein(a), or Lp(a), is a major but often overlooked contributor to heart attack, stroke and aortic valve disease — yet real‑world testing remains rare. A retrospective review of testing across a large, diverse health system found Lp(a) measurement was performed at very low rates over the past decade, even as awareness of its importance has grown; roughly one in five adults carry high Lp(a) levels that raise cardiovascular risk. (ajmc.com)
Lp(a) is a genetically determined lipoprotein related to LDL cholesterol but with unique properties that promote blood clotting and arterial plaque. Because genetics mainly determine an individual’s Lp(a) level, it is relatively stable across life and-unlike LDL-cannot be reliably lowered by diet or exercise. A single blood test can establish a person’s Lp(a) status; laboratories report results in either mg/dL or nmol/L, and patients and clinicians must note the unit when interpreting thresholds. (uclahealth.org)
Multiple analyses and surveys identify persistent barriers to wider Lp(a) testing: low clinician familiarity, inconsistent lab methods and reporting, limited integration into routine risk assessments, and the historical absence of approved Lp(a)-lowering drugs. These obstacles help explain why testing rates have stayed far below the proportion of people likely to have elevated Lp(a), creating missed opportunities for earlier risk identification and family cascade screening. (pmc.ncbi.nlm.nih.gov)
Knowing an elevated Lp(a) level matters because it adds to a person’s overall atherosclerotic cardiovascular disease (ASCVD) risk and is linked not only to heart attack and stroke but also to calcific aortic valve disease. Clinicians currently manage high Lp(a) by aggressively controlling modifiable risks-especially lowering LDL cholesterol, blood pressure and glucose-and by addressing lifestyle factors. At the same time, targeted therapies to reduce Lp(a) are in late‑stage clinical trials, offering hope for future direct treatment options. (heart.org)
Recent research also shows the value of combining biomarkers: long‑term studies found that models including Lp(a) alongside LDL and markers of inflammation (hsCRP) improved prediction of cardiovascular events in women, underscoring how Lp(a) can refine risk assessment when used with other tests. Clinicians are advised to consider testing at least once in life-sooner for people with a family history of premature ASCVD or belonging to groups with higher average Lp(a) levels, such as people of African or South Asian descent. (mindbodygreen.com)
Experts and reviews urge health systems to standardize Lp(a) assays, add testing prompts to electronic records, and expand clinician education so high‑risk patients are identified equitably. As targeted therapies progress through trials, widening access to reliable Lp(a) measurement is seen as a necessary step to translate growing scientific knowledge into better prevention and treatment. (pmc.ncbi.nlm.nih.gov)
Original Source: https://www.ajmc.com/view/despite-high-awareness-of-lp-a-as-a-cvd-risk-factor-testing-rates-are-low
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Publish Date: 2026-02-19 03:12:00
